Medicare Update

Hello Everyone,

Please enjoy the information contained in this edition of Frontier Focus. Please be sure to share it with your members, colleagues, providers and office billing staff. Thank you for your continued efforts to broadcast Medicare information to the providers in Region VIII.





Table of Contents



1. Special Open Door Forum: Medicare Imaging Demonstration Project



2. FIFTH in a Series of Eight Special Open Door Forums on DMEPOS Competitive Bidding



3. Important Medicare Information About DMEPOS Supplier Accreditation and the Round 1 Rebid of the DMEPOS Competitive Bidding Program



4. New from the Medicare Learning Network®



5. September 27th is World Heart Day!



6. Extra Help for Beneficiaries Paying for Prescription Drugs









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1. Special Open Door Forum: Medicare Imaging Demonstration Project



Centers for Medicare & Medicaid Services

Special Open Door Forum:

Medicare Imaging Demonstration Project

Thursday, October 1, 2009

2:00 pm – 4:00 pm ET



The Centers for Medicare & Medicaid Services (CMS) is holding a Special Open Door Forum (ODF) to share the proposed key elements of the Medicare Imaging Demonstration design. This demonstration was authorized by Section 135(b) of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) for the purpose of collecting data regarding physician use of advanced diagnostic imaging services. For purposes of this demonstration, advanced diagnostic imaging services are defined as diagnostic magnetic resonance imaging, computed tomography, and nuclear medicine.



Tentative Agenda:



1. Demonstration overview



2. Advanced imaging procedures



3. Decision Support Systems and guidelines



4. Quality



For a copy of the presentation slides and more general information about the demonstration, please see the demonstration website: http://www.cms.hhs.gov/DemoProjectsEvalRpts/MD/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=3&sortOrder=descending&itemID=CMS1222075&intNumPerPage=10



Telephone participants will be given an opportunity to speak and will be asked to limit comments to 2 minutes.



Interested parties may submit comments or input in written form to ImagingDemo135b@cms.hhs.gov by noon ET on Wednesday, September 30, 2009.

We look forward to your participation.



To participate by phone:

Dial: 1-800-837-1935 & Reference Conference ID: 29805623



Persons participating by phone are not required to RSVP.



Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.

An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Tuesday, October 13, 2009



For automatic emails of Open Door Forum schedule updates, E-Mailing list subscriptions and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .

Thank you for your interest in CMS Open Door Forums.

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2. FIFTH in a Series of Eight Special Open Door Forums on DMEPOS Competitive Bidding



Centers for Medicare & Medicaid Services

Special Open Door Forum:

Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program Bidders’ Conference-

How a Bid is Evaluated



Tuesday, September 29, 2009

2:00 pm – 3:00 pm Eastern Time

Conference Call Only



Please join us for the fifth in a series of eight Special Open Door Forum (ODF) bidders’ conferences for the Round 1 Rebid of the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) competitive bidding program. At this Special ODF, we will walk through the bid evaluation process. This will include discussions about the components of bid evaluation and calculations of the single payment amounts.



Reminder: Registration for user IDs and passwords is open. We recommend that Backup Authorized Officials register no later than October 9, 2009. The target deadline for Authorized Officials (AO) interested in participating in the Round 1 Rebid to register was September 14, 2009. If you are an AO who has not yet registered – do it TODAY! To register, go to the Competitive Bidding Implementation Contractor (CBIC) web site: www.dmecompetitivebid.com.



Background:



On August 3, 2009, the Centers for Medicare & Medicaid Service (CMS) issued the bidding timeline for the Round 1 Rebid of the DMEPOS competitive bidding program and initiated a comprehensive bidder education campaign. CMS’ Competitive Bidding Implementation Contractor (CBIC) is the focal point for bidder education. Please visit the CBIC's dedicated website, www.dmecompetitivebid.com, for important information, including bidding rules, user guides, frequently asked questions, policy fact sheets, checklists, and bidding information charts. The CBIC toll-free help desk, 1‑877‑577‑5331, is open to help bidders with all of their questions and concerns. All suppliers interested in bidding are urged to sign up for e-mail updates on the home page of the CBIC website.



We look forward to your participation.

Special Open Door Participation Instructions:

Dial: 1-800-837-1935 & Reference Conference ID: 23045547

Note: TTY Communications Relay Services are available for the Hearing Impaired. For TTY services dial 7-1-1 or 1-800-855-2880. A Relay Communications Assistant will help.



An audio recording of this Special Forum will be posted to the Special Open Door Forum website at http://www.cms.hhs.gov/OpenDoorForums/05_ODF_SpecialODF.asp and will be accessible for downloading beginning Wednesday, October 7, 2009.



For Open Door Forum schedule updates, E-Mailing list subscriptions, and to view Frequently Asked Questions please visit our website at http://www.cms.hhs.gov/opendoorforums/ .



Thank you for your interest in CMS Open Door Forums.

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3. Important Medicare Information About DMEPOS Supplier Accreditation and the Round 1 Rebid of the DMEPOS Competitive Bidding Program



New MLN Matters Article Now Available!



SE0925 - Important Medicare Information about DMEPOS Supplier Accreditation and the Round 1 Rebid of the DMEPOS Competitive Bidding Program

Critical changes are coming that will affect the way Medicare pays for DMEPOS and how Medicare determines who can bill for DMEPOS. This new Special Edition article provides important reminders about some of these changes that will be occurring in the very near future. Suppliers are urged to review this article and be sure they are prepared for these changes in order to continue providing DMEPOS to Medicare patients. For more information, please see the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0925.pdf on the CMS website.

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4. New from the Medicare Learning Network®



Recent MLN Matters articles of particular interest:



· MLN Matters Special Edition Article #SE0926 -- 2009 - 2010 Seasonal Influenza (Flu) Resources for Health Care Professionals

CMS reminds health care professionals that Medicare Part B reimburses health care providers for seasonal flu vaccines and their administration. (Medicare provides coverage of the seasonal flu vaccine without any out-of-pocket costs to the Medicare patient. No deductible or copayment/coinsurance applies.) All adults 65 and older should get seasonal flu and pneumococcal immunizations. People with Medicare who are under 65 but have chronic illness, including heart disease, lung disease, diabetes or end-stage renal disease should get a seasonal flu shot. For more information, please see the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0926.pdf on the CMS website.



· MLN Matters Special Edition Article #SE0923 - Reminder about Correct Billing Changes for Certain Skilled Nursing Facility (SNF) Residents

This special edition article is being provided because CMS has identified an issue related to the planned implementation of new CMI sets for Fiscal Year 2010. For FY 2010, the payment rate ordering will change for a limited number of residents in rural facilities. For more information, please see the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0923.pdf on the CMS website.

· MLN Matters Special Edition Article #SE0924 – Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications

CMS issued revised Medicare enrollment applications for physicians, non-physician practitioners and other suppliers (except DMEPOS suppliers) using the CMS-855B and/or the CMS-855I to enroll or make a change in their enrollment information. This Special Edition outlines the significant revisions to the Medicare CMS-855B and CMS-855I enrollment applications. For more information, please see the article located at: http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0924.pdf on the CMS website.

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A revised Section 1011: Federal Reimbursement of Emergency Health Services Furnished to Undocumented Aliens Fact Sheet that describes available funding, eligibility and enrollment services to undocumented aliens as detailed in Section 1011 of the Medicare Modernization Act of 2003 (MMA) is now available in downloadable format from the Medicare Learning Network at http://www.cms.hhs.gov/MLNProducts/downloads/Section_1011_Fact_Sheet.pdf



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The Expanded Benefits Brochure, which provides information about the initial preventive physical examination (IPPE), ultrasound screening for abdominal aortic aneurysms (AAA), and cardiovascular screening blood test benefits covered under Medicare, has been newly revised and updated! It is now available on the Medicare Learning Network in a downloadable, printable format at the following address:

http://www.cms.hhs.gov/MLNProducts/downloads/expanded_benefits.pdf

A printed hardcopy version will be available at a later date. For more products related to Medicare-covered preventive services, please visit our preventive services educational products website at: http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp .



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The Medical Privacy of Protected Health Information Fact Sheet has been updated and is now available through the Medicare Learning Network. This fact sheet contains resources and information regarding the privacy rules provided in the Health Insurance Health Insurance Portability and Accountability Act of 1996 (HIPAA). To download this fact sheet, please visit:

http://www.cms.hhs.gov/MLNproducts/downloads/SE0726FactSheet.pdf

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5. September 27th is World Heart Day!



The Centers for Medicare & Medicaid Services (CMS) is asking the provider community to keep their patients with Medicare healthy by encouraging them to take advantage of Medicare-covered preventive services.



Medicare provides coverage for cardiovascular screening blood tests, ultrasound screening for abdominal aortic aneurysms (AAA), and smoking and tobacco-use cessation counseling for qualified beneficiaries.

What Can You Do?

As a health care professional who provides care to seniors and others with Medicare, you can help protect the health of your Medicare patients by educating them about their risk factors and reminding them of the importance of Medicare-covered preventive services that are appropriate for them.

For More Information

CMS has developed several educational products related to Medicare-covered preventive services:



o The Guide to Medicare Preventive Services for Physicians, Providers, Suppliers, and Other Health Care Professionals ~ this newly revised comprehensive resource provides coverage and coding information on the array of preventive services and screenings that Medicare covers, including cardiovascular screening blood tests, AAA screenings, and smoking and tobacco-use cessation counseling. http://www.cms.hhs.gov/MLNProducts/downloads/mps_guide_web-061305.pdf

o The MLN Preventive Services Educational Products Web Page ~ provides descriptions and ordering information for Medicare Learning Network (MLN) preventive services educational products and resources for health care professionals and their staff. http://www.cms.hhs.gov/MLNProducts/35_PreventiveServices.asp

o Quick Reference Information: Medicare Preventive Services ~ this double-sided chart provides coverage and coding information on Medicare-covered preventive services, including smoking and tobacco-use cessation counseling, and AAA and cardiovascular screenings. http://www.cms.hhs.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf

o Expanded Benefits brochure ~ this brochure provides information on coverage for Medicare-covered cardiovascular blood test and AAA screenings. http://www.cms.hhs.gov/MLNProducts/downloads/expanded_benefits.pdf

o Smoking and Tobacco-Use Cessation Counseling brochure ~ this brochure provides information on coverage for Medicare-covered smoking and tobacco-use cessation counseling.



Please visit the Medicare Learning Network for more information on these and other Medicare fee-for-service educational products.



Thank you for helping CMS improve the health of patients with Medicare by joining in the effort to educate beneficiaries about the importance of taking advantage of preventive services covered by Medicare.

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6. Extra Help for Beneficiaries Paying for Prescription Drugs



Do You Know Someone Who Is Having Trouble Paying For Prescription Drugs?

Medicare Can Help!



If an individual has limited income and resources, they may qualify for extra help from Medicare. It could be worth over $3,300 in savings on prescription drug costs per year.
Encourage people with Medicare to file for Extra Help online: https://s044a90.ssa.gov/apps6z/i1020/main.html or by calling Social Security at 1-800-772-1213 to apply over the phone.
State Health Insurance Information Program (SHIP) offices can assist with the application. Find contact information for a local SHIP Counselor at http://www.medicare.gov/contacts/static/allStateContacts.asp or by calling
1-800-MEDICARE.

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Lucretia James

Division of Medicare Health Plans Operations
Centers for Medicare & Medicaid Services
Region VIII
1600 Broadway, Suite 700
Denver, CO 80202
(303) 844-1568
lucretia.james@cms.hhs.gov